Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Front Public Health. 2024 Sep 23;12:1389760. doi: 10.3389/fpubh.2024.1389760. eCollection 2024.
Northern Thailand experiences high levels of air pollution in the dry season due to agricultural waste burning and forest fires. Some air pollutants can enter the bloodstream, and the liver has the role of detoxifying these along with other harmful substances. In this study, we assessed the effects of long-term exposure to air pollutants on liver cancer mortality in this area.
A cohort of 10,859 primary liver cancer patients diagnosed between 2003 and 2018 and followed up to the end of 2020 were included in the study. Extended time-varying covariates of the annually averaged pollutant concentrations updated each year were utilized. The associations between air pollutants and mortality risk were examined by using a Cox proportional hazard model.
Metastatic cancer stage had the highest adjusted hazard ratio (aHR) of 3.57 (95% confidence interval (CI):3.23-3.95). Being male (aHR = 1.10; 95% CI: 1.04-1.15), over 60 years old (aHR = 1.16; 95% CI: 1.11-1.21), having a history of smoking (aHR = 1.16; 95%CI: 1.11-1.22), and being exposed to a time-updated local concentration of PM of 40 μg/m (aHR = 1.10; 95% CI: 1.05-1.15) increased the mortality risk.
We found that air pollution is one of several detrimental factors on the mortality risk of liver cancer.
泰国北部在旱季会因农业废弃物燃烧和森林火灾而遭受高水平的空气污染。一些空气污染物可以进入血液，而肝脏具有解毒这些物质以及其他有害物质的作用。在这项研究中，我们评估了长期暴露于空气污染物对该地区肝癌死亡率的影响。
本研究纳入了 2003 年至 2018 年间诊断为原发性肝癌且随访至 2020 年底的 10859 例患者。利用每年更新的逐年平均污染物浓度的扩展时变协变量。使用 Cox 比例风险模型来检查空气污染物与死亡率风险之间的关联。
转移性癌症分期的调整后危险比（aHR）最高，为 3.57（95%置信区间[CI]：3.23-3.95）。男性（aHR=1.10；95%CI：1.04-1.15）、60 岁以上（aHR=1.16；95%CI：1.11-1.21）、有吸烟史（aHR=1.16；95%CI：1.11-1.22）和暴露于时间更新的局部浓度为 40μg/m 的 PM（aHR=1.10；95%CI：1.05-1.15）会增加死亡风险。
我们发现空气污染是导致肝癌死亡率的几个不利因素之一。
